The Selling of Kate Cox: How the Media Failed to Report the Full Story
Kate Cox should be cradling a little boy right now—a three-month-old at this writing and very much a wanted child.
In late 2023, the Dallas-area mother of three (living) children became the focal point of one of the savviest PR efforts in America’s 52-year-old debate over legalized abortion. Articulate and attractive, with a compelling story, she rose from anonymity to a seat of honor beside former First Lady Jill Biden at then-President Joe Biden’s State-of-the-Union address in early 2024. When the president referred to her in his speech, Cox got a standing ovation.
In this article I will not so much rehash her story as question the dozens of reporters who published fawning articles detailing (in their view) the near-martyrdom of this north Texas mom with the bad luck to have a dire pregnancy in a state that (post-Dobbs) has become something out of A Handmaid’s Tale. These were writers who—as far as I could determine—never did fact checks about problem pregnancies, never questioned the narrative about aborting fetuses with handicaps, and never bothered to search out opposing points of view.
Cox was 20 weeks pregnant with a girl when she learned the child had Trisomy 18, a genetic condition that is often—but not always—fatal. One famous example of a survivor is Bella Santorum, eighth child of former Sen. Rick Santorum, who is now a dark-eyed, dark-haired sixteen-year-old.
Cox was told that her child had a “full” Trisomy 18, and had no chance of survival. Moreover, Cox was experiencing cramping and some leakage from her uterus and feared her daughter would eventually die in her womb or at birth. Neither scenario appealed to her, so, in the words of her court petition to abort the pregnancy, “It is not a matter of if I will have to say good-bye, but when. I do not want to continue the pain and suffering that has plagued this pregnancy . . . I desperately want the chance to try for another baby . . .” Thus, Cox became the first woman in the country to sue for the right to an abortion since the Supreme Court’s Dobbs decision overturned Roe v. Wade in 2022. She was ultimately turned down by the Texas State Supreme Court—but in the interim, she left the state to get an abortion in New Mexico. Meanwhile, the activist Center for Reproductive Rights, which Cox had approached for help, had spread the word about her situation. The media pile-on started right away. From The Guardian1, we hear how “in a state like Texas, [pregnancy complications] have become newly dangerous, threatening women with potentially disfiguring health complications, along with unimaginable heartbreak, as the state’s multiple bans have mandated grotesque and inhumane treatment of doomed pregnancies.”
“Disfiguring health complications?” There’s nothing I found in the court record that even hinted at that.
Then there was a breathless advocacy piece2 by Monica Hesse (formerly gender columnist for the Washington Post until early this year, when her employer did away with the position and transferred her to the opinion section). Hesse’s article was topped by a lovely portrait of the blond-haired Cox in a black dress or tunic covered with an ornate leaf design. She is shown gazing down at her stomach, with both hands protectively placed where her unborn child should be. Although—depending on when the photo was taken—it’s possible the child (whom she had named Chloe) had already been terminated. The pregnancy “severely compromised” Cox’s health, Hesse wrote. Cox’s physician, Dr. Damla Karsan, had given a statement to the court saying—and this wording is important—that it was her “good faith belief and medical recommendation” that Cox should be granted permission to have an abortion. Cox, the doctor wrote, “has a life-threatening physical condition aggravated by, caused by, or arising from her current pregnancy that places her at risk of death or poses a serious risk of substantial impairment of her reproductive functions.”
The Texas State Supreme Court ruled that Karsan was hedging as to whether her patient’s condition was truly life-threatening. Karsan knew the law, the judges said; if it was life threatening, the law allowed the doctor to abort the pregnancy.
Why did the doctor not go ahead? For starters, State Attorney General Ken Paxton had threatened with massive fines, imprisonment, and loss of medical licenses any doctor or hospital that helped Cox abort her child. A court authorization would give Karsan and her staff the necessary cover.
Using phrases like “Cox’s battered body” and “unspeakable anguish,” Hesse concluded that what happened to Cox was a “travesty of justice.”
Clearly, this was a complicated case, so I began looking about to see how other journalists had covered the story. What I found were a number of assertions—some of them contradictory—that Cox and her advocates made and that journalists never bothered to fact check. They included:
• That bearing this child would destroy her fertility;
• That if she continued with this pregnancy, her uterus would rupture;
• That Trisomy 18 was almost always a “lethal abnormality.”
Incidentally, Trisomy-18 itself is not dangerous to a mother’s health. A simple read of the Trisomy Foundation’s website3 states that it is very rare for such pregnancies to endanger the mother.
According to a transcript of the hearing that I accessed through the New York Times,4 Cox’s lawyer stated that if she were denied the abortion, doctors would either have to induce labor (if she miscarried or if the child died in utero) or administer a C-section (if the child survived until birth). Because C-sections cause scarring, there would be a chance that her future fertility might be affected, meaning she might not be able to have more children.
At this point, Hesse should have seen an obvious gap in logic. It’s not unheard of for women to have multiple C-sections (Ethel Kennedy had five), so what’s all this clamor about her “future fertility” being affected? Hadn’t Cox gone into the pregnancy unfazed by the knowledge that she could have a third C-section—until she learned that the child was handicapped?
And if a C-section causes scarring, what about a D&E (dilation and extraction) abortion, which is what you get at 20 weeks when the unborn child is the size of a banana? There are risks to a D&E as well, including perforation of the uterus and severe bleeding; dilators are put into the cervix the night before to widen it, so it’s no picnic. Why was Cox willing to risk the wellbeing of her uterus, aka future fertility, in a second-trimester abortion, but not in a C-section?
Simple answer: Because Cox wanted to try again and was open to undergoing a C-section for a healthy future baby. She just didn’t want to have a C-section for this baby.
As she tellingly said near the top of the transcript: There’s no outcomes at the end of this, where I take home a healthy baby girl.
I glanced at another long piece about Cox in Time magazine5 that repeated Karsan’s narrative: that if the baby died in utero, Cox could get a significant infection; that a third C-section brought increased risk of uterine rupture; that being induced (instead of aborting the child) or having a C-section might mean she would never have more children, etc.
Reporters swallowed this narrative hook, bait, line, and sinker. Not one article I read was honest enough to state that Cox was cutting her losses in favor of a healthy child, and if she had to abort one to do so, that was her pragmatic choice.
Instead, reporters wrote up scenarios where Cox’s unborn daughter was endangering her health, her fertility, even her very life, though her life was never in danger. Story after story simply ran with this one point of view, with no attempt to even consider that there might be another truth out there. The temptation to portray a distressed, highly likeable, and attractive woman telling the compelling story that she was being forced to bear a highly flawed child was too strong to turn down.
The one reporter who offered a very different narrative on Trisomy 18 was Jennifer Brookland, a children’s health reporter with the Detroit Free Press. She wrote a long article on local kids who also had full Trisomy 18, but whose mothers brought them to term.6 The families were patients at the University of Michigan’s C. S. Mott Children’s Hospital in Detroit, which took an aggressive approach to saving such children. The result: 90 percent of Trisomy 18 kids born there were able to go home from the hospital.
One wonders what would have happened had Cox lived in Detroit instead of Dallas.
After learning about Cox, I, like Brookland, wondered if I was hearing the entire story. Then I heard about Yessica Guerrero, then 34, a woman living just north of Houston. She was pregnant with a daughter with anencephaly, where much of the brain and part of the skull is simply missing. The child was due in September 2024, and the mother was planning to bring her to term. Guerrero had four living children; another daughter, who also had anencephaly, died at birth in 2017.
For a woman to weather not just one horrific tragedy, but two, floored me. I called Guerrero to ask if I could follow her along in her pregnancy, and I learned she was part of a network of other Texas women who’d had the same experience—and who also had decided not to abort. Next I learned of yet another group, an Austin-based network called carrytoterm.org, that offers advice on “pregnancy continuation” for “life-limiting conditions.”
Why am I not reading about these people? I thought. If I, living in Seattle, can find out about these networks, why aren’t Texas journalists digging them up? I tried pitching Guerrero’s story to one national magazine, but my editor contact didn’t think it was original or fresh enough. Not long before, this publication had profiled abortionist Warren Hern, who’s been written up a zillion times. But my idea didn’t cut it.
Fortunately ReligionUnplugged did pick up my story (please see it in Appendix A), but that one response showed me the secular media aren’t racing after narratives that show women choosing their handicapped children.
This wasn’t the first time I’d noticed such blindness. During the 16 years I lived inside the Beltway (1995-2012), I read more than enough pieces in the Washington Post and other mainstream media about the noble efforts of nurses and doctors in abortion clinics to keep said clinics open, but I could count on the fingers of one hand sympathetic profiles of pro-life figures. Working for the comparatively understaffed Washington Times, I unearthed Isaiah’s Hope, an organization based in Silver Spring, Md., that encouraged women to bring endangered pregnancies to term. It began when Anna Lise “Cubby” LaHood found out in the spring of 1988 that her unborn son Francis would die shortly after birth from polycystic kidney disease. What saved Francis from an abortion was a Catholic priest telling her husband Dan that even the birth of a stillborn child had meaning. I wrote about them in 2009.7
I wondered at the time: Why aren’t reporters covering the experiences of women who have brought these kids to term? Isaiah’s Hope was not a tough group to find. Nor were other groups around the DC area with similar stories.
But they were too conservative. Too Catholic. Too counter-cultural.
A lot of reporters cannot bring themselves to question pro-abortion assumptions. For the Cox story, I found one writer who did so: Delaney Coyne’s analysis for the Jesuit publication America.8 Coyne is the one writer who did observe that it was a bit iffy whether Cox’s life was actually in danger and noted that some doctors may exaggerate how life-threatening a pregnant woman’s condition actually is so she can get an abortion. Still, in the battle for public opinion, voters will side with a sympathetic Kate Cox-like character every time, so prolifers need to change their strategy in such cases.
But this is hard to do when so much confidential medical information is involved that the public has no access to.
While I was working on the Yessica Guerrero article9 and interviewing her doctor about methods of delivering infants with poor life expectancy, with the Cox case in mind, I asked whether induction can rupture a uterus.
“It’s very rare but it can,” the doctor replied. “Outside of a patient with a prior surgery on her uterus, it’s almost unheard of.”
Cox had had two C-sections, so yes, that’s a type of uterine surgery. But it was not a given that rupture would happen. That was the scenario Cox’s Dr. Karsan drew, but I began to wonder how disinterested a participant she was, as Karsan is one of two physician plaintiffs in another abortion rights suit Zurawski v. State of Texas. Although the lawsuit does say the two women met, and Karsan had reviewed Cox’s records, nothing specified that the two had a doctor/patient relationship, nor that Karsan had examined Cox before the latter filed the lawsuit.
One other factoid I picked up from Guerrero’s maternal medicine specialist: Texas Children’s Hospital in Houston was where people who wanted to keep their Trisomy-13 and Trisomy-18 babies came for support. The clinic is called the Texas Children’s Fetal Center, and it lists just about every birth defect and fetal anomaly there is.
Had Cox even been told such a place was available if she chose to bring her daughter to term? Had she even wanted to know? I wonder if Cox projected into the future, saw nothing but pain and suffering, and decided she didn’t want to go there. A second-trimester abortion was the fastest way to solve this problem.
But first, she and her doctor and lawyers had to persuade everyone that she had no other choice. This is where I castigate the media for failing to say there were other choices and refusing to present them.
Or, if they did present them, it was in such an unattractive way that no sane person would want to follow in their footsteps. When the Texas Tribune did a piece on an east Texas woman who brought her non-viable twins to term, 10 the gritty narrative dwelt on the repulsive nature of the infants, who died soon after birth. And to be sure, the deformities the twin boys had were not pretty.
But abortion isn’t pretty, either.
One light in the journalistic darkness I’ve discovered is Amy Kuebelbeck, a copy editor for the Minneapolis Star-Tribune whose son Gabriel died soon after birth in 1999 of hypoplastic left heart syndrome. What she discovered in her grief was not only other parents walking the same path, but hospitals that had palliative care for a newborn who is expected to die within a few hours or days. These places are known as perinatal hospices.
Kuebelbeck realized that it could make a huge difference to parents who were trying to decide whether to abort such a child or bring him or her to term if they knew that many hospitals offer this service. So she began compiling a website: perinatalhospice.org, and a list—now at 273 perinatal centers in the United States and 96 abroad. Hospitals don’t tend to advertise these places, she told me, because they don’t wish to sell themselves as places where people die.
These places are still worth a story, I replied. Why do so few reporters go there?
“If you’ve never been in this situation or known someone who has, the entire thing is so foreign to you,” she said. “You see this situation as so horrific, the only solution is to help someone to get out of it as soon as possible. That’s what they see as compassion.”
And some doctors don’t help.
Judging from the parents she’s heard from, “There’s a strong expectation among medical professionals that the only rational thing . . . was to end the pregnancy. I continue to hear from people who felt pressured or dismissed because they wanted to continue.”
Within six months of her abortion, Cox was pregnant again. She announced her pregnancy at the Democratic National Convention in Chicago, where the late Cecile Richards of Planned Parenthood fame introduced her as “another great Texas heroine.” The last we saw of the mother was in mid-October in a televised ad11 that ran on behalf of U.S. Rep. Colin Allred (D-Texas), who was running against Sen. Ted Cruz. She was wearing a forced smile and appearing in a black dress. The camera only briefly touching on her very pregnant belly, Cox spoke out against her state’s “devastating” abortion ban that had forced her to flee to New Mexico. Allred, she promised, “will restore common sense to our health care laws.”
Allred lost to Cruz, and the reaction to Cox when the video was posted on YouTube video was testy. Typical comment: “Why is she smiling when talking about killing her kid?”
Since then, Cox has totally dropped off the media radar. She turned down my interview request, even to confirm the birth had gone well. She desired privacy, I was told, after a nearly two-year media blitz. With the election, the mood around the country has shifted, and the hero’s welcome she enjoyed a year ago is an echo now.
NOTES
1. Moira Donegan, “Kate Cox begged Texas to let her end a dangerous pregnancy. She won’t be the last.” The Guardian, Dec. 12, 2023.
2. Monica Hesse, “The Heartless Treatment of Kate Cox in Texas,” The Washington Post, Dec. 12, 2023.
4. Sabrina Tavernise, “The Woman Who Fought the Texas Abortion Ban,” the New York Times, Dec. 14, 2023.
5. Charlotte Alter, “How Kate Cox Became a Reluctant Face of the Abortion-Rights Movement,” Time Magazine, March 27, 2024.
6. Jennifer Brookland, “Texas woman seeking abortion argued Trisomy 18 was lethal. Michigan children prove it’s not.” Detroit Free Press, Dec. 27, 2023.
7. Julia Duin, “Choosing not to abort babies with disabilities,” the Washington Times, May 10, 2009.
8. Delaney Coyne, “There are no black-and-white answers in the Texas trisomy 18 abortion case,” America, Dec. 21, 2023.
9. Julia Duin, “Mothers who keep their fatal pregnancies turn to faith: ‘Who am I to kill this baby?’” ReligionUnplugged.com, Oct. 23, 2024.
10. Eleanor Klibanoff, “She was told her twin sons wouldn’t survive. Texas law made her give birth anyway,” the Texas Tribune, Oct. 11, 2023.
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Original Bio:
Julia Duin has worked as an editor or reporter for six media outlets, the latest as Newsweek’s contributing editor for religion. She has published seven books, and has master’s degrees in journalism and religion. Her latest book, Finding Joy: A Mongolian Woman’s Journey to Christ, tells the story of Yanjmas Jutmaan, a Mongolian activist for women’s rights, a counselor, and statistics expert. Julia lives in the Seattle area.
